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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543801073
Report Date: 05/15/2019
Date Signed: 05/16/2019 11:32:51 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CUTLER CHILD DEVELOPMENT CENTER #2FACILITY NUMBER:
543801073
ADMINISTRATOR:CRISTINA ESPINOFACILITY TYPE:
850
ADDRESS:12890 SCHOOL AVENUETELEPHONE:
(559) 528-1834
CITY:CUTLERSTATE: CAZIP CODE:
93615
CAPACITY:100CENSUS: 65DATE:
05/15/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Sylvia AvilaTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Diana Martinez conducted an unannounced case management inspection to follow up on an unusual incident that involved two day care children while on the playground on 4/26/19. The Unusual Incident Report (LIC 624) was received by Fresno Community Care Licensing on 5/6/19. LPA met with Center Supervisor Sylvia Avila. The incident occurred in the play ground when Child #1, who was sitting in a wagon, was being pulled by Child #2. When the wagon stopped, Child #1 attempted to climb out of the wagon and Child #2, being unaware the other child was standing up to climb out, resumed pulling the wagon. Child #1 fell back and out of the wagon and hit the back of his head on the concrete. The child sustained a slight bump to the back of his head. First aid was administered, parent was contacted, and child was taken to his doctor for treatment on day of incident, Friday, 4/26/19. Child returned to facility on Monday, 4/29/19, without restrictions or limitations as per the clearance from his doctor. Teacher-child ratio was in compliance. Child is doing well. LPA observed the area where incident occurred and the plastic jumbo pull wagon children were using. LPA did not observe any tripping hazards. The wagon child was riding in is designed to transport children and is large enough to transport up to four children. The accident occurred when Child #1 stood up at the same time that Child #2 resumed to pull the wagon after pausing momentarily. This was an isolated incident and staff took appropriate measures to address the child’s injury following agency policies and procedures.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, no deficiency is being cited.

Exit interview conducted with Center Supervisor Sylvia Avila and a copy of this report was provided and discussed. A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Diana D MartinezTELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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